The nurse is reviewing a new prescription for propranolol (Inderal) for a patient with coronary artery disease (CAD). The nurse would call the physician and question this prescription if the patient has which history?
1. History of asthma
2. Also taking antioxidants
3. Also taking simvastatin (Zocor)
4. History of bleeding disorders
1
Rationale 1: Class II beta-blockers such as propranolol are used to reduce heart rate and myocardial contractility and in the treatment of supraventricular tachycardia. These drugs may cause bronchospasm and are contraindicated for patients with asthma.
Rationale 2: Antioxidants may be taken concurrently.
Rationale 3: Simvastatin may be taken concurrently.
Rationale 4: Bleeding disorders are not a contraindication for propranolol use.
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